Doctor Name: | TANAM AHMED |
NPI Number: | 1043475155 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | MT193279 |
Business Practice Address: | 120 Cypress Edge Dr Suite 207 Palm Coast, FL - 321648453 |
Business Phone Number: | 3865864390 |
Business Fax Number: | 3865864392 |
Mailing Address: | 120 Cypress Edge Dr, Suite 207 PALM COAST |
State: | FL |
Postal Code: | 321648453 |
Phone Number: | 3865864390 |
Fax Number: | 3865864392 |
NPI Enumeration Date: | 07/29/2008 |
NPI Last Update Date: | 01/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT193279 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |